The major long-term goal of the proposed research is to prevent and reduce the costs in human suffering and fiscal resources that are associated with excessive alcohol consumption, through the use of brief intervention (BI). Another long-term aim is to explain changes in alcohol use that occur with or without the aid of formal treatment. The specific aim of the research are to: (1) investigate the effectiveness of two BIs for alcohol problems, advice and motivational enhancement, that are delivered in family practice and general internal medicine clinics; (2) investigate patient pretreatment stage of change regarding alcohol use as a moderator of the main effects of BIs on alcohol consumption outcomes; (3) investigate patient factors as overall predictors of Bl alcohol consumption outcomes in primary care clinics. The major predictors evaluated will include gender, coping skills, and severity of alcohol dependence; and (4) explore the mechanisms of the effectiveness of BIs. Subjects will be 244 men and 244 women 21 years of age or older who are primary care patients at five clinic sites. Eligibility for the study will be determined by initial telephone screening and in-person baseline assessment. Following the baseline evaluation subjects will be randomly assigned to one of 3 intervention conditions, advice, motivational enhancement, or standard care control. The BI will occur shortly after the BL assessment. Follow-up assessments will occur by phone (1,3 months) or in person (6,12 mo.) and will include multimethod measures of substance use, alcohol and nonalcohol related service utilization, treatment-related factors, and health status and medical services utilization. Collaterals will be interviewed by phone about the subject's behavior at all assessments. The proposed study is significant for its potential to refine the use of a treatment approach that could save billions of dollars through limiting or preventing adverse consequences of heavy alcohol use. The study also will further the understanding of change in drinking behaviors.